Soft Tissue Massage Flashcards
What are benefits of soft tissue massage?
Promotes local and systemic relaxation
Increases local blood flow
Breaks down adhesions
Facilitates venous return
What are specific situations STM is used in an AT setting?
Edema removal
Chronic back/neck injuries
Tendonitis and ITB friction syndrome
Chronic muscular injuries-scar tissue
What are indications of STM?
Pain Anxiety Edema Decreased ROM Muscle spasm Trigger points Adhesions/Scar tissue
What are contraindications of STM?
Acute inflammation Infection-systemic/skin Skin Conditions DVT Tissue Irritability Malignancies
What is Effleurage?
most versatile and frequently used
“Stroking”-smooth, firm, continuous motion, adapt speed
Enhances venous flow, deep effleurage provides some stretch to muscle
Effluerage: Soft tissue
fingerpads
stimulates sensory nerves
Effluerage: Deep tissue
use palms or knuckles
stimulates deep tissues
Basic Effleurage
Palms of the hands conform to tissue (parallel to body part)
Start off very light gliding over skin and begin gentle increase of pressure
Can use palms, fingers, thumbs, fists, forearms
Shingles Effleurage
Continuous alternating (b/w hands) stroking
Strokes overlay each other
One hand always remains in contact
Done many times parallel to the spine
Petrissage
Lifting, kneading, wringing, rolling tissues
Targets muscle
Progress depth of treatment-alter speed
basic 2-handed kneading: lift, squeeze, release ST
Purpose of Petrissage?
Separates muscle fiber, fascia, and scar tissue
Milks the muscle of waste products, assists with venous return and relaxes muscle.
Skin rolling: Petrissage
Tissue picked up b/w thumb and first two fingers, gently pull away from deeper tissues
Thumbs can push forward causing a rolling effect
Tapotement
Percussion
Stimulates muscular and systemic relaxation
Desensitization of irritated nerve endings
Types of Tapotement
gentle tapping or pounding
Most common: “hacking (karate chop)”
Pincement
Cupping
Hacking
hands face each other
hands and wrist held loosely
rapid percussion mvmt
Rapping
similar to hacking but using lightly closed and loosely held fists
Cupping
Rapidly alternating force
Cup hand so thumb and fingers are slightly flexed and palmer surface contracted
Contract surface of skin with outside surface of cupped hand
Pincement
Rapid gentle mvmt of picking up skin b/w thumb and first two fingers
aka: “plucking”
Deep Transverse Friction
Friction, cross-friction, DTF, deep massage, deep transverse/friction massage
Developed by James Cyriax
What is DTF indicated for?
muscle, ligament, and tendon injury
Proposed mechanism of action for DTF
pain relief via gate control/endogenous opiate release
Collagen re-orientation during maturation phase
prevention of adhesions
ruptures existing adhesions-increased ROM
Increases local blood perfusion
Friction
breaks up adhesions by way of increasing space b/w collagen fibers
Fingers and skin move together
directly over lesion
What are the two types of friction?
Transverse
Friction
Transverse friction massage
strokes perpendicular to tissue fibers
thumbs or fingertips stroke in opposite direction
Circular friction massage
Used to:
break up scar tissue
soften a healing scar
Tx protocol for DTF
Cyriax: 6-12 sessions, alternate days
Starkey: once per day
Mvmt should be perpendicular to fibers
Edema Reduction Massage Preparation
elevate body area
apply massage lubricant to skin
clinician is positioned distal to extremity
What is the stroke sequence
begin proximal to the edematous area
long, slow deep strokes towards torso
move starting point slightly distal every 4th or 5th stroke
when it starts to be more distal to edema, begin working back towards starting point
Termination
Remove medium
if appropriate: AROM exercises
Compression wrap
Encourage pt to drink water to assist in flushing metabolic waste
